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What Is The Reason For Fluctuation In The TSH Levels?

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Posted on Mon, 22 Dec 2014
Question: Hello Doctor,

From January 2014 i'm using thyronorm tablet. Initially in my first test TSH level is 9.1 doctor suggested Thyronorm 50mcg after 4 months TSH level is 4.2 after that doctor increased the dose to 75mcg after 4 months surprisingly my TSH level was 0.06 now. please advise me which dose would be acurate for me?
doctor
Answered by Dr. Minal Mohit (31 minutes later)
Brief Answer:
62.5 mcg would be right for you.

Detailed Answer:
Dear Sir,
You were diagnosed as primary hypothyroid and were put on 50 mcg of thyroxine and then escalated to 75mcg. This escalation actually was a little high for you.
Let us make it 62.5 mcg of thyroxine. I think that would suit you perfectly. Discuss about this with your treating doctor before changing dosage. Recheck after 6 weeks and let me know. But at the same time do tell me your symptomatic status as well about reports whatever done so far or you can upload reports.
Regards!

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Minal Mohit (24 hours later)
Dear Dr XXXXXXX XXXXXXX

Thanks a lot for your suggestion.. i will start using 62.5 mcg before that i have few confusions please advise.

In XXXXXXX 2014 when the Hypothyroidism was diagonised and when i started using Thyronorm tablet after 2 months i'm not able play my game daily and felt severe Bone & Joints & Ancle pains and my stamena level became low then i raised a same concern with doctor than he told me that these pains are not due to thyronorm tablet but my sense is not convinced and asked another doctor for second opinion then he asked me to take vitamin D3 test.

Surprisingly my vitamin D3 level was only 15 then doctor suggested me to take "D3 Must 2k" tablet everyday along with thyronorm tablet early morning but my inconvenience is still same not change in bone pains.

I would like to tell you my symptoms which i'm suffering now.

Black shaded and dull skin on face.
Not able to concentrate on my work and studying books.
Bad looking hair lifeless.
Feeling sleepy always.
Bone & Joint & Ancle pains.
Gastic trouble.

How may days i have to take vitamin D3 tablet?
Is the 62.5 mcg Thyronorm is available in the market?

One more problem which i'm facing is from last two years back side of my neck was swelling and big pimple kind of things on my shoulders but good thing was these are getting reduced once i started Thyronorm tablet but not completely still i'm not sure that these are because of hypothyroidism?

By seeing my TSH level 0.06 i was a bit scared and stopped taking thyronorm tablet from last 3 days. Suddenly from this 3 days i'm feeling active and having peace of mind. Please let me know when i have to start taking 62.5 mcg Thyronorm?

Sorry for writing an essay and i hope u will understand my situation.

Regards,
XXXX
doctor
Answered by Dr. Minal Mohit (43 minutes later)
Brief Answer:
I understand Sir!

Detailed Answer:
Dear Sir, Hi! I'll try to answer one by one.
1. thyroxine does affect bone metabolism, so thyroxine is always supplemented with calcium and vitamin D.
2. dose of calcium is upto 1gm per day and Vitamin D is 60,000IU once a week.
3. initially after starting thyroxine patients do feel uncomfortable due to change in metabolism
4. dull skin and dark complexion can be due to thyroid imbalance on either side.
5. boils are not related to thyroid disorders.
6. restart 62.5 thyroxine from tomorrow. it is available in this strength in the market by brand name thyrox, or thyronorm.
regards!
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Minal Mohit

Endocrinologist

Practicing since :1998

Answered : 836 Questions

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What Is The Reason For Fluctuation In The TSH Levels?

Brief Answer: 62.5 mcg would be right for you. Detailed Answer: Dear Sir, You were diagnosed as primary hypothyroid and were put on 50 mcg of thyroxine and then escalated to 75mcg. This escalation actually was a little high for you. Let us make it 62.5 mcg of thyroxine. I think that would suit you perfectly. Discuss about this with your treating doctor before changing dosage. Recheck after 6 weeks and let me know. But at the same time do tell me your symptomatic status as well about reports whatever done so far or you can upload reports. Regards!